3rd Trimester

Cytotec vs. Cervadil

Hi, was wondering if anyone here has used cytotec or cervadil to start an induction. My GYN recommended Cytotec but when I googled it , its not recommended by the FDA for labor induction and found some scary information. Anyone here have a positive experience? Im thinking of suggesting Cervadil instead.
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Re: Cytotec vs. Cervadil

  • Here are the differenes: Cytotec is a gel that is inseted into the cervix to soften/ripen it to begin labor. The disadvantage is that if you get overstimulated, there's nothing you can do it about it. It is a stronger ripener than Cervidil. Cervidil is a little, flat, plastic thing on a string that is inserted into the cervix the same. However, if you are overstimulated, they can easily pull it out by the string. It's slightly weaker and hurts like a b!tch to be put in.

    I was induced with Cervidil at 39 weeks due to pre-e and baby's HR dropping during an NST. During the NST, it showed I was already in "early labor" b/c I was contracting every 3-5 min, but they were weak (I couldn't even feel some of them). The cervidil was put in at 4pm...since it's flat, plastic and rectangular shape, it felt like I had little cuts inside of me from the insertion...I had to lie flat for 2 hours, then I was able to walk around. It usually stays in for 12 hours. At 9pm, I started having painful contractions. It normallydoes not put you into labor, but since I was in early labor, it jump started it. 12 hours later it was removed (didn't hurt as much to be removed)...but long story short...I had a c-section about 24 hours after the initial insertion of cervidil.

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  • Mr Dr said she'd be using cytotec for my induction. I had heard bad things on here about it so I called her on it.  She said the biggest risk with it is over stimulation, so she only uses a quarter of the dose. She's been using it for 8 years (not sure that's an effective argument). It also eliminates the need for pitocin.

    I did find a peer reviewed study on the use of cytotec for induction.  In this particular study,  significantly less births ended in c-section than did with pitocin, labors were significantly quicker, and incidence of bad effects to mom and baby were the same.

     I'm still nervous about it, but I trust my dr, and am nervous about all iduction methods anyway.

  • image g8orell:

    Here are the differenes: Cytotec is a gel that is inseted into the cervix to soften/ripen it to begin labor. The disadvantage is that if you get overstimulated, there's nothing you can do it about it. It is a stronger ripener than Cervidil. Cervidil is a little, flat, plastic thing on a string that is inserted into the cervix the same. However, if you are overstimulated, they can easily pull it out by the string. It's slightly weaker and hurts like a b!tch to be put in.

    Close, but not true.  Cytotec is administered in tablet form - which is simply inserted into the vagina.  I've typed this info in a number of other posts, so I'll just copy/paste it here for you:

    Labor can be induced with a handful of different agents.  Cervidil (dinoprostone) inserts, Cytotec (misoprostol) tablets, Prostaglandin E-2 vaginal suppositories, or Prepidil (dinoprostone) gel.  These drugs are placed high in the vagina (near the cervix) to cause ripening (dilatation and effacement) of the cervix.

    Cytotec (misoprostol) is not FDA-approved for this use, but it is considered generally safe and is used routinely.  It is actually one of the go-to choices for controlling post-partum bleeding following delivery or a D&C (and it is usually given rectally for this purpose).  Yes, it was originally approved for preventing gastric ulcers - but its mechanism of action (it's a prostaglandin E1 analog) lent itself to use and study for the purpose of labor induction.  This drug has been around since 1988 and available as a generic for many years - so there's absolutely no financial incentive for anyone to go and pursue an FDA indication for obstetrical use (i.e., there isn't enough money to be made from a patent for the FDA-indicated use to justify the expenditure of the research studies needed to get the indication). 

    Pitocin (oxytocin) via an IV infusion can also induce labor.  Pitocin is the same as the natural oxytocin your hypothalamus produces.  Sometimes, cervical ripening and breaking the amniotic sac is enough to stimulate contractions.  But most women will need to follow the ripening process with an oxytocin infusion.

    I won't get into a debate here about the benefit of one induction agent over another.  I've been a hospital pharmacist for  14+ years, so I can tell you what the literature says:  that Cytotec is cost-effective and safe when used properly and in the appropriate subset of obstetrical patients. 

    There are a number of posters on this board and others who will discourage you from having an induction with Cytotec based on some information available on the internet.  My advice is to talk with your provider about any concerns you have, ask lots of questions about the drugs they'll use, and come up with a plan that is comfortable you.

    2 years TTC with 5 losses, 1 year recovering, 6 months applying for adoption approval, and almost a year waiting for a placement. Then, a miracle BFP at age 36!


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  • They used Cytotec for my induction and I didn't have any negative side effects from it. It did what it was supposed to do and even made my contractions start before they began the pitocin.

  • I had both. Cytotec actually put me into labor with no bad side effects, while cerdavil did nothing. I would trust your doctor's recommendation over the internet personally.
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  • Here in Canada they often do cytotec or cervadil first and I have rarely heard of anybody needing the drip after that.  And here they are willing to do 2+ doses of cervadil or cytotec and induce multiple times before going to other methods.

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  • I have had both. I needed pitocin with both.

    Although I experienced no side effects from the cytotec it is not recommended by the FDA for use in pregnant women.

    I agree with pp. Any concerns you have should be discussed withyour Dr. If you are uncomfortable using cytotec - there are other aternatives.

  • I had prostaglandin gel and everything went smoothly.  I had the gel inserted at 4pm ( .5cm dilated) and returned to the hospital in full labor around 11:30pm ( 4cms dilated) - started pushing at 11:00am.
  • I had the Cervadil put in, and while it was uncomfortable with the doctor jamming it up there, it certainly was not excruciatingly painful.  And I consider myself a wimp.  I admit though that it can differ from person to person and with the doctors' skills.
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  • (lurker, obviously)

    The company that makes cytotec actually sent a letter to OBs saying that it's not for obstetric use.  If the company that profits off of it says not to use it for inductions, I would say no, too.  Cytotec is significantly cheaper than cervadil, which may be one reason doctors like to use it (in addition to how powerful it is, as PP mentioned.)

     I had a foley catheter (I think--it transferred saline from one side of the cervix to the other to dialate) and pitocin and that sure got things going.  The only problem I had with pitocin was that the monitor wasn't picking up my contractions so they kept turning it up.  Not cool.  Once they put in an internal monitor, they turned it almost off.  Wink

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  • It's definitely within your rights as a patient to request one over the other. Like a pp said, the FDA and the company that make Cytotec don't recognize it in use for inductions. And the fact that it's a pill that needs to be cut up means it's not as exact as Cervadil (and it can't be taken out once it's put in). Those would be my reasons to request Cervadil, at any rate. Good luck deciding!
    DS1 - Feb 2008

    DS2 - Oct 2010 (my VBAC baby!)

  • Thanks everyone! Really appreciate your input and have until monday pm to decide, taking it all into consideration. Thanks again! :)
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  • image BakerMommy:

    (lurker, obviously)

    The company that makes cytotec actually sent a letter to OBs saying that it's not for obstetric use.  If the company that profits off of it says not to use it for inductions, I would say no, too.  Cytotec is significantly cheaper than cervadil, which may be one reason doctors like to use it (in addition to how powerful it is, as PP mentioned.)

    True, Searle did send out this letter.  But bear in mind that drug manufacturers routinely send out letters like this regarding off-label uses of their products.  Because Searle did not have an FDA-approved indication for this purpose, they were legally barred from promoting its sale for that use.  These "Dear Doctor" letters are often part of a strategy (used by many manufacturers) to avoid heat from the FDA for promoting off-label uses of products.  Additionally, letters were sent out when the "black box" warning was added to the product stating that its use was contraindicated in pregnant patients (specifically because it is so effective at causing labor).  Again, this is routine practice in the pharmaceutical industry and not necessarily an indictment against the product.

    References to these facts on websites run by malpractice attorneys should be evaluated in the context with which they were developed - to solicit clients.  I'm not arguing that tragic cases have not occurred - this is true for many drugs on the market, including Cytotec.  But your best source of information should be the healthcare provider you work with and trust to deliver your baby.

    If you're interested in reviewing the medical literature on the use of Cytotec, I encourage you to visit www.PubMed.org and enter the search terms "misoprostol and labor induction" into the search box for a concise list of recent publications on the use of this drug.  Clicking on an article title in the list will usually take you to an abstract (or summary) of the article with brief results and conclusions.

    2 years TTC with 5 losses, 1 year recovering, 6 months applying for adoption approval, and almost a year waiting for a placement. Then, a miracle BFP at age 36!


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  • I know nothing about Cytotec, but I was induced with Cervadil for #1. I was 50% effaced and barely a fingertip dilated. I was give the Cervadil at 7:30pm and had my son at 11pm. It was a fast, hard delivery because the contractions were right on top of each other, but really I have no complains.

     They expected to give me the Cervadil and then 12 hrs later give me Pitocin, but instead my labor started immediately. No Pitocin needed.

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